Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 33350 | AL |
N | 207VX0000X | Obstetrician | 1144580861 | AL |
NPI | 1144580861 |
---|---|
Provider Name | Dr. William Ray Stroud III |
First Address | Decatur, AL 35601-5541 |
Second Address | Mobile, AL 36604-3302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2012 |
Last Update Date | 28/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L3767R | ALABAMA LICENSE (01) | AL |